Evidence map›Paper›PMID 28115858›Full record

ArticleClinicoEconomics and outcomes research : CEOR2017

Cost-effectiveness analysis of combination antifungal therapy with voriconazole and anidulafungin versus voriconazole monotherapy for primary treatment of invasive aspergillosis in Spain.

Santiago Grau, Jose Ramon Azanza, Isabel Ruiz, Carlos Vallejo, Josep Mensa, Johan Maertens, Werner J Heinz, Jon Andoni Barrueta, Carmen Peral, Francisco Jesús Mesa and 4 more

Open access · goldAbstract read
In one paragraph

Article in ClinicoEconomics and outcomes research : CEOR, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Echinocandins - structure, mechanism of action and use in antifungal therapy.Journal of enzyme inhibition and medicinal chemistry · 2022
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 9 institutions in 4 countries.

Santiago GrauPharmacy Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona.
Jose Ramon AzanzaClinical Pharmacology Department, Clínica Universidad de Navarra, Pamplona.
Isabel RuizInfectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona.
Carlos VallejoHematology Department, Hospital Universitario Donostia, San Sebastián.
Josep MensaInfectious Diseases Department, Hospital Clínic de Barcelona, Barcelona, Spain.
Johan MaertensHematology Department, University Hospital Gasthuisberg, Leuven, Belgium.
Werner J HeinzHematology/Oncology Department, Medizinische Klinik und Poliklinik II, Universitätsklinikum, Würzburg, Germany.
Jon Andoni BarruetaMedical Department.
Carmen PeralEconomics and Outcomes Research Department, Pfizer S.L.U, Alcobendas.
Francisco Jesús MesaMedical Department.
Miguel BarradoClinical Trials Department, Trial Form Support, Madrid, Spain.
Claudie CharbonneauPharmacoeconomics Department, Pfizer International Operations, Paris, France.
Darío Rubio-RodríguezPharmacoeconomics Department, Health Value, Madrid, Spain.
Carlos Rubio-TerrésPharmacoeconomics Department, Health Value, Madrid, Spain.
Pharmacoeconomics and Health Outcomes Research Iberia (Spain) · ESBiogipuzkoa Health Research Institute · ESClinica Universidad de Navarra · ESHospital Clínic de Barcelona · ESPfizer (France) · FRPfizer (United Kingdom) · GBUniversitair Ziekenhuis Leuven · BEUniversitat Autònoma de Barcelona · ESVall d'Hebron Hospital Universitari · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveAccording to a recent randomized, double-blind clinical trial comparing the combination of voriconazole and anidulafungin (VOR+ANI) with VOR monotherapy for invasive aspergillosis (IA) in patients with hematologic disease or with hematopoietic stem cell transplant, mortality was lower after 6 weeks with VOR+ANI than with VOR monotherapy in a post hoc analysis of patients with galactomannan-based IA. The objective of this study was to compare the cost-effectiveness of VOR+ANI with VOR, from the perspective of hospitals in the Spanish National Health System.

methodsAn economic model with deterministic and probabilistic analyses was used to determine costs per life-year gained (LYG) for VOR+ANI versus VOR in patients with galactomannan-based IA. Mortality, adverse event rates, and life expectancy were obtained from clinical trial data. The costs (in 2015 euros [€]) of the drugs and the adverse event-related costs were obtained from Spanish sources. A Tornado plot and a Monte Carlo simulation (1,000 iterations) were used to assess uncertainty of all model variables.

resultsAccording to the deterministic analysis, for each patient treated with VOR+ANI compared with VOR monotherapy, there would be a total of 0.348 LYG (2.529 vs 2.181 years, respectively) at an incremental cost of €5,493 (€17,902 vs €12,409, respectively). Consequently, the additional cost per LYG with VOR+ANI compared with VOR would be €15,785. Deterministic sensitivity analyses confirmed the robustness of these findings. In the probabilistic analysis, the cost per LYG with VOR+ANI was €15,774 (95% confidence interval: €15,763-16,692). The probability of VOR+ANI being cost-effective compared with VOR was estimated at 82.5% and 91.9%, based on local cost-effectiveness thresholds of €30,000 and €45,000, respectively.

conclusionAccording to the present economic study, combination therapy with VOR+ANI is cost-effective as primary therapy of IA in galactomannan-positive patients in Spain who have hematologic disease or hematopoietic stem cell transplant, compared with VOR monotherapy.

Indexed as

anidulafungincost-effectivenessgalactomannaninvasive aspergillosisvoriconazole

Identifiers

PMID28115858
PMCPMC5221484
OpenAlexW2562998757

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.